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What Causes Swelling And Tingling On Leg Post Sclerotherapy?

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Posted on Mon, 1 Dec 2014
Question: I had sclerotherapy on my left leg 8 months ago. The treated vein on my left shin was about 3-1/2" long and left a brown line with an oval bruise looking area at the site of injection about 1/2" long. Shortly after treatment, my left leg started to tingle all the way into my foot which continues to this day. My foot actually fell asleep a few times waking me up in the middle of the night. During workouts the vein area would throb.

Two months ago, I saw a specialist who drained what they called a hematoma (the oval bruise at the injection site). After which, the drained hematoma got infected and was treated with topical and oral antibiotics. I continue to experience the tingle throughout each and everyday. The specialist said I had crystallized trapped blood in the vein that would eventually be absorbed thereby ending the tingling. Does this sound correct? The brown line as fade quite a bit since but the hematoma sight is still brown but reduced significantly. It's been 8 months and this treatment was cosmetic only. I had NO prior issues with my leg before this. I'm very concerned about the health of my leg and am waiting for this tingling to stop. Can you please advice?
doctor
Answered by Dr. Dr. Rahul Kumar (17 minutes later)
Brief Answer:
photograph required

Detailed Answer:
Hello
Thanks for the query. I understand your concern and will try to help you to the maximum.
Can you please upload a photograph of the involved area.
Its very important for me to see the area in order to give a proper diagnosis.
There is an option to upload photos on right side of query page. Please utilize that. You can also email reports to YYYY@YYYY with subject as attn Dr XXXXXXX Kumar.
Waiting for your response.
Thank you
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Rahul Kumar (16 hours later)
Hi, I have provided some attachments. Please review them.
doctor
Answered by Dr. Dr. Rahul Kumar (6 hours later)
Brief Answer:
it will heal

Detailed Answer:
Hello
Thanks for the photograph.
I can see there is slight swelling on your legs. Sclerotherapy is done to destroy dilated veins.
Slowly these veins get fibrosed and close completely.
This may take upto an year or slight more than that as the process is slow.
Once this has occurred tingling sensation will disappear.
I would suggest you to use elastic stocking. This will compress the sclerosed vein and help in faster healing.
Let me know if you Have any other doubts.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Dr. Rahul Kumar (1 hour later)
Thank you so much for your response.

I tried using my compression stockings last week but the compression on the drained hematoma caused it to ache. Since I wasn't sure what the overall problem was, I stopped wearing them.

Is it ok to compress that area? Will it cause any problems or nerve damage as that area is tender? How much sooner will this heal with the stockings/how long (months) do I need to wear them? Lastly, should I wear them when I workout?

Additionally, unless my leg is elevated while sitting, my lower leg not only tingles but I feel quite a bit of pressure in my lower left leg from the very top of my calf/shin to my ankle and foot. Within five minutes, I need to move that leg around or elevate it.

It's made me wonder if the circulation in my lower leg has been altered? Why is this happening? Will all of this go away as well?
Lastly, what happens when a healthy vein has been injected/treated? Would that cause permanent damage? I suspect that vein was healthy as the specialist said long straight veins (as this was) are healthy. This is the other reason for my concern.
I'm sorry to write again but I just noticed the photos in the upload are all the same. I actually uploaded 9 different photos. The one in this file doesn't show the area fully.

Those photos are in the email I sent to the address you provided. Did you by chance receive that email as these photos will give you a better view?
doctor
Answered by Dr. Dr. Rahul Kumar (11 hours later)
Brief Answer:
Leg elevation is must

Detailed Answer:
Hello
Thanks for the follow up.
I can understand your concern.
I will try to answer all your queries.
You can put cotton at the site of hematoma and then use elastic bandage.
This will relieve pressure.
It is important to elevate legs as there is chance of fluid accumulation due to gravity, leading to swelling.
Best is to sleep with slightly elevated legs by putting a pillow under legs.
You should use stockings while doing exercise.
Normal vein is not injected with sclerosant.
There are two veins long saphenous and short saphenous.
The doctor must have said that long is fine.
He might have injected the short one.
I have received only one photo but i can estimate your problem with that.
Feel free to ask any other doubts.
Thank you

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Rahul Kumar (1 hour later)
Thank you for the further accessment. For your review, I uploaded a better photo that shows the hematoma area and the light brown vein. The vein starts at the drained hematoma and extends up and off to the right about 4 inches as you can see.

Will "all" of these symptoms (pressure in leg and tingling) heal and go away?

Has my circulation been damaged temporarily or permanently?

How many months will I need to wear the compression stockings?

How many months do I need to elevate my leg?

Can I wear the knee high version or do I need to wear a thigh high daily?

Thank you so much.
doctor
Answered by Dr. Dr. Rahul Kumar (11 hours later)
Brief Answer:
6 months

Detailed Answer:
Hello
Thanks for the follow up.
Yes these symptoms will decrease gradually.
As I mentioned earlier there are two draining veins.
The short one has been damaged but the long can still drain out blood, so this damage is not permanent.
You need to wear stockings for another 6 months at least.
Similarly elevation is advised for another 6 months.
Knee high version is more than enough, up to thigh is not necessary.
Sorry again I could not find the attached photographs.
Feel free to ask any doubts.
I am always there to help you.
Wishing yo a good health.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Rahul Kumar (1 hour later)
Thank you for the follow up.

Regarding the remaining draining vein in my leg, is it fully capable of handling all of functions of the closed vein?

What if something happens to that vein? Will my leg be ok?

It sounds like I may need to wear the stockings longer than the next six months. When will I know that I don't need them anymore?

I had no idea that the vein was one of two draining veins for my leg. I don't understand why my doctor wouldn't have advised me of this before injecting the vein. I never would have agreed to that had I'd known as the health of my leg takes priority.

I am very concerned about this. Again, this was a strictly cosmetic procedure. That vein wasn't causing me any distress and wasn't that visible.

Regarding the photo, the one currently attached to this file should be the new one. Once open, you may need to scroll down to see the area.
I also need to mention that when I was given the antibiotic for the infected drained hematoma, the tinglingly extended up to my inner thigh. When I mentioned this to the specialist, he shrugged it off. But since then, I still experience tingling up to my inner thigh.

Could this be related to the closed draining vein?

Also, is it at all possible that she injected the large saphenous vein?

Would an ultrasound or MRI give definitive answers regarding this?
Also, do I need to wear the stockings at night?

Thank you so much.

doctor
Answered by Dr. Dr. Rahul Kumar (11 hours later)
Brief Answer:
color Doppler

Detailed Answer:
Hello
Thanks for the follow up.
Tingling is not due to antibiotics but due to injection given in the vein. It irritates local veins. 6 months will be enough I think. You don't need to wear stocking in night. Just elevate your legs in night.
Don't worry the long vein is good enough to drain.
Just relax and give time to your leg to heal.
Sorry I saw all the images again. All are same. Color Doppler will give an exact picture.
Don't be anxious. Keep updating me.
Thank you
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Rahul Kumar (28 minutes later)
Thank you. I will try to relax. The information you provided was all new to me as the specialist didn't mention any of it.

Just to be clear, the tingling I feel up to my inner thigh is normal for a vein closed in my lower leg?

After six months, my leg should retun to normal with no tingling, pressure or possible swelling?

Thank you.
doctor
Answered by Dr. Dr. Rahul Kumar (8 minutes later)
Brief Answer:
you will recover in 6 month

Detailed Answer:
Hello
Yes tingling is due to sclerosant only.
As the nerve concentration is more in inner thigh area you might be feeling tingling in that area.
Just get a color Doppler when you are free. It's not urgent.
You will recover in 6 months. Just relax.
Wishing you all the best.
Thank you
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Rahul Kumar (1 hour later)
Thank you
doctor
Answered by Dr. Dr. Rahul Kumar (6 hours later)
Brief Answer:
welcome

Detailed Answer:
You are most welcome.
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Dr. Rahul Kumar

Dermatologist

Practicing since :2010

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What Causes Swelling And Tingling On Leg Post Sclerotherapy?

Brief Answer: photograph required Detailed Answer: Hello Thanks for the query. I understand your concern and will try to help you to the maximum. Can you please upload a photograph of the involved area. Its very important for me to see the area in order to give a proper diagnosis. There is an option to upload photos on right side of query page. Please utilize that. You can also email reports to YYYY@YYYY with subject as attn Dr XXXXXXX Kumar. Waiting for your response. Thank you